Inspection on 11/08/05 for Aston House

This inspection was carried out on 11th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Aston House 04/03/09

Aston House 02/09/08

Aston House 22/11/07

Aston House 30/10/06

Aston House 20/03/06

Aston House 22/03/05

Aston House 16/08/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Aston House 45 Hampton Park Road Hereford Herefordshire HR1 1TJ Lead Inspector Debra Lewis Announced 11 August 2005 10:00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Aston House Address 45 Hampton Park Road, Hereford, Herefordshire HR1 1TJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01432 267996 Mr Mark Zylinski Mrs Lesley Ann Pinwell Care Home 16 Category(ies) of MD Mental disorder (16) registration, with number MD(E) Mental disorder over 65 (1) of places Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Managers Training: The manager must undertake a recognised course in mental health within the next year. It was noted that this training had now been completed and the manager was waiting for the results. She later confirmed that she had successfully passed the exams, so this condition will now be removed. Date of last inspection 22 March 2005 Brief Description of the Service: Aston House is a substantial detached property set back from the road in a residential area of Hereford city. The house has 10 single bedrooms, 3 double bedrooms, shared lounge, dining room, bathroom facilities and a good sized garden with a conservatory. The home is registered to offer services for up to 16 adults who have experienced some mental or emotional health problems. For some service users it is their ongoing home, for others it may be less permanent, on the way to more independent living, but for all the aim is to provide a normal, homely and supportive environment. The home has been owned since 1988 by Mr Mark Zylinski, the registered provider. He is a qualified psychologist and visits the home on a regular basis. The registered manager is Mrs Lesley Pinwell, who has worked at the home for 15 years. Leslie became the home’s manager in 2004 and has completed the registered manager’s award. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the inspector’s first visit to the home since becoming the lead inspector for the service. The aim was to see what progress had been made since the last inspection, and to meet service users and staff. The inspection took place over 5 hours during a Thursday in August. The inspector met many service users and spoke at length with 3 of them. The inspector also met and spoke with the registered manager, the registered provider and 3 other staff members. Service users and staff made the inspector very welcome in the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 4 The needs of new service users were being properly assessed before they moved into the home. People were able to visit the home to try it out before moving in. EVIDENCE: There had been no new service users since the last inspection. However files sampled included social services’ assessments. In addition the home had completed their own profiles of individual service users’ needs. Service users admitted in the past few years confirmed they had visited the home e.g. for meals and overnight stays, before moving in. (Standard 5: Contracts were not fully checked, but it was noted that changes had been made in response to a previous requirement. This standard will be looked at in more detail on a future occasion.) Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Service user plans now contained the necessary information for each person’s care, and service users confirmed they had had (varying degrees of) involvement with this. Risk had been assessed and service users were able to live independent lifestyles. EVIDENCE: Since the last inspection the home had completely revised their service user plans. The inspector sampled some and found all necessary information, including details of specific needs concerning physical health problems as well as social and emotional needs. There were also risk assessments, individual for each service user. These had been prepared with the input of the service user where this was possible. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 and 17 Leisure activities were now available often enough for the liking of service users, though they had to pay extra for holidays. Service users liked the food. They could choose meals and any special diets were catered for. EVIDENCE: The inspector discussed leisure activities with staff and several service users. Since the last inspection the staff levels had improved due to employment of a cook. Staff and service users felt there was now sufficient time for leisure activities and described a range of them. Staff were now recording individuals’ activities. Some people had been on a camping holiday; others were due to go to Spain or to a holiday camp in the UK. The inspector was told that everyone would be offered a holiday, although probably not everyone would take up the offer. The holidays were paid for by individual contributions from service users, not from the home’s budget. The inspector joined service users for lunch, saw menus and records of food, and spoke with the cook and service users about meals. Special diets were Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 11 catered for, including low-potassium and vegetarian diets. Service users were able to choose meals when the menu was planned, and options were available. Special meals and cakes were provided for birthdays. Service users said the food was very good, and the lunch provided was nutritious and tasty. The home had not started completing nutritional risk assessments for service users; the inspector will provide a sample format. The home had started to monitor service users’ weight regularly. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Staff gave suitable support with personal, physical and emotional needs. Some service users managed their own medication. Staff managed other medication properly. EVIDENCE: Very little personal care was needed, mainly advice or reminders. Revised service user plans showed how staff helped with physical and emotional health needs. Service users were happy with how staff helped them. Some service users managed their own medication and confirmed that they had locked storage space for it. The inspector saw written risk assessments covering people’s ability to safely manage their own medication, signed agreements to take prescribed medication, and records of current medication and administered medication. Storage was suitable and staff administration of medication (observed by the inspector) was appropriate. (Standard 21: It was noted that people’s “last wishes” regarding funerals and their property had been recorded.) Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not checked, but had been found to be met at the last inspection in March 2005. EVIDENCE: The inspector saw a complaints book, which had no complaints or concerns recorded. It would be good practice to encourage recording of even relatively minor concerns, to show that all concerns were taken seriously and to make it easier to monitor any trends. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The home was generally well maintained, with some minor repairs and redecoration needed. Most of this was due to be done in the near future. EVIDENCE: The inspector saw all communal areas of the home, but did not see bedrooms. A few repairs were needed e.g. a toilet with a broken seat, a shower with damaged paintwork where a leak had been repaired. The décor was generally sound; some redecoration of the home was due to be done in the autumn, the inspector was told this was done every year according to need. The home was clean and free from odour (apart from some cigarette smoke). The home now had planning permission to convert the garage to a smoking lounge. This was due to be done in the autumn, and when completed the rest of the home would become a non-smoking area. Some safety issues previously identified (unrestricted window openings, radiator covers) had been, or were due to be, addressed (see standard 42). Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 33 Staff had suitable NVQs (national vocational qualifications) and were well liked by service users. Since recruitment of a cook, care staff usually had enough time to allow for all aspects of service users’ care. EVIDENCE: The inspector was told that more than half of the staff held, or were soon to complete, NVQ (national vocational qualification) 3 or 4 in care or promoting independence. The deputy and another staff member were about to begin the registered managers’ award. Service users spoke positively about current staff members. There were now enough staff to allow for time with individual service users, spent doing leisure activities such as swimming or in one-to-one sessions. The home was managing the holiday period by using regular relief staff who knew the home well. The inspector saw a staff rota, which should include hours worked by domestic staff as well as care staff. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The manager was experienced, qualified and competent; she had done further training in mental health. The home was beginning to undertake quality assurance surveys which had led to some changes. The system should be made more thorough. Health and safety issues were mostly well managed, with some work still to be completed. EVIDENCE: Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 17 The registered manager has worked at the home for many years and became the registered manager last year. She had just completed a recognised mental health course with the Open University and was awaiting the result. The quality assurance system was being put into practice via questionnaires to service users. These had led to some changes e.g. to the layout of the dining room, type of holidays offered and meals. The results had not been collated and put into a development plan, and views of family, friends and other interested people (e.g. social workers, GPs) had not been sought. (Standard 41 – records: although records were not fully checked, it was noted that those requested were all available in the home.) Some health and safety concerns were identified at the last inspection. The home had now completed a risk assessment on unguarded radiators and had ordered a cover to be fitted on one which had a high surface temperature. First floor windows had been restricted (except where they opened onto a flat roof rather than a long drop). Temperature regulators had been ordered for water supplies, but the contractor had failed to turn up, so the registered provider was pursuing alternative suppliers. The home had evidence that the required precautions against legionella had been carried out. In addition the inspector saw further evidence of competent health and safety management. Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x 2 x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Aston House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 x E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 24 Regulation 13 Requirement A smoke free sitting room area must be provided for service users and staff. Timescale for action 31.12.05 2. 24 23 3. 39 24 (Timescales of 31.1.05 and 30.6.05 not met, but planning permission has been obtained for a suitable garage conversion.) Repairs and redecoration must 31.12.05 be carried out where needed, specifically in the downstairs WC and downstairs shower room. The home must evaluate the 31.12.05 results from the quality assurance process and draw up a development plan. (Timescale of 30.5.05 not met) 4. 5. 6. 39 42 42 24 13 13 The quality assurance system 31.12.05 must include consultation with service users representatives. Radiator covers must be fitted to 30.9.05 any radiators assessed as a possible risk to service users. Hot water taps on the baths 30.9.05 must be thermostatically controlled to reduce the potential of scalding. (Timescale of 30.4.05 not met) Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 3, 35 Good Practice Recommendations A basic training programme for staff in relevant mental health topics should be formalised to identify and deliver core topics. (Carried forward from previous inspection and not fully checked on this occasion) Service users holidays should be funded from the homes budget, not by service users. It would be good practice to record relatively minor concerns in order to show they are taken seriously and to monitor trends. The staff rota should include all hours worked by domestic staff as well as care staff. 2. 3. 4. 14 22 33 Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 21 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Aston House E52 S24691 Aston House V240877 110805.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!